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Centene CEO Michael Neidorff. Photo: Steven Ferdman/Getty Images

Centene and WellCare have cleared all federal and state antitrust reviews, and today they finalized their merger — combining into the largest health insurer by membership, with 23.4 million covered people.

Why it matters: The health insurance industry gets a lot more consolidated with this deal, and competition will decline within state Medicaid programs and among federal Medicare plans.

The big picture: A combined Centene and WellCare essentially functions as a branch of state and federal governments, because almost all of its $100 billion in annual revenue flows from taxpayer-funded health care programs.

  • Two-thirds of revenue come from Medicaid, where Centene and WellCare serve as the insurance gatekeepers for low-income people in 30 states. The two companies always competed against each other in Medicaid bids.
  • A growing portion of the combined company's revenue stems from private Medicare Advantage plans and Medicare prescription drug plans.
  • WellCare doesn't sell any plans in the Affordable Care Act marketplaces, but Centene is the largest ACA insurer. Taxes subsidize a vast majority of those ACA premiums.

Between the lines: Centene had to sell some of its Medicaid and Medicare plans to alleviate competitive concerns raised by antitrust authorities, but those assets are just getting shifted to other dominant insurers.

  • CVS Health bought Centene's Medicare and Medicaid plans in Illinois, and Anthem acquired WellCare's Medicare and Medicaid plans in Missouri and Nebraska.
  • Health insurance is all about scale, and the biggest players are getting bigger.

Go deeper

18 mins ago - Economy & Business

Boeing gets huge 737 Max order from Ryanair, boosting hope for quick rebound

Ryanair low cost airline Boeing 737-800 aircraft as seen over the runway. Photo by Nik Oiko/SOPA Images/LightRocket via Getty Images

Dublin-based Ryanair said it would add 75 more planes to an existing order for Boeing's 737 Max airplanes, a giant vote of confidence as Boeing seeks to revive sales of its best-selling plane after a 20-month safety ban following two fatal crashes.

The big picture: Ryanair's big order, on the heels of breakthrough vaccine news, is also a promising sign that the devastated airline industry might recover from the global pandemic sooner than expected.

Ben Geman, author of Generate
23 mins ago - Energy & Environment

Trump sets auction for Arctic refuge drilling rights before Biden takes office

Photo: Win McNamee/Getty Images

The Interior Department on Thursday said it will auction oil drilling leases in Alaska's Arctic National Wildlife Refuge in early January.

Why it matters: The procedural step would make it harder for President-elect Joe Biden to thwart drilling in the region, even though any actual development is years away.

Rep. Sean Patrick Maloney elected chair of House Democrats' campaign arm

Rep. Sean Patrick Maloney. Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Rep. Sean Patrick Maloney (D-N.Y.) on Thursday was elected chair of the Democratic Congressional Campaign Committee for the 2022 cycle, narrowly defeating Rep. Tony Cardenas (D-Calif.) 119 to 107, Politico reports.

Why it matters: Maloney will be tasked with protecting House Democrats' slim majority in 2022 after they underperformed in November's election, losing seats in down-ballot races across the country.

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